Interview: “Social sciences need to be taught to dental students”
As a senior lecturer in social science at the University of Bristol’s dental school, Dr Andrea Waylen understands the importance of the behavioural and social sciences for developing well-rounded dentists with an ability to communicate effectively. Dental Tribune International recently spoke with her about an article she wrote for the British Dental Journal on this topic as well as about some of the shortcomings of current pedagogical approaches.
Dr Waylen, what exactly is involved in teaching behavioural and social sciences to dental students? Are there any particular considerations that need to be emphasised?
If you look at the General Dental Council (GDC) learning outcomes for dental practice preparation as well as at other learning outcomes, there is an emphasis on behavioural and social sciences and how they can influence communication with patients or their families as well as influence teamwork with colleagues. Throughout all of these learning outcomes, there is an indication that social sciences need to be taught to dental students. However, these outcomes are not prescriptive in their nature, and so there’s a lot of opportunity for teachers within dental schools to develop their own approaches to teaching behavioural and social sciences.
“There’s a lot of opportunity for teachers within dental schools to develop their own approaches to teaching behavioural and social sciences.”
How did you go about developing your own personal approach, then?
I started here in Bristol 12 years ago with pretty much a blank canvas—there was already social science teaching going on at that time, but it was largely undertaken by public health dentists who didn’t necessarily provide a discipline-specific input. In the 12 years since I’ve been here, I’ve reshaped the social sciences curriculum and worked with others to develop its current format.
When I started changing the curriculum, I went to the available GDC guidelines, consulted papers that had already been published that were relevant to the topic and considered what happens when I go to the dentist as a patient myself. From there, I developed an outline for teaching social sciences that spoke to not just the patient experience but also the GDC learning outcomes in place at that time.
What are the benefits of integrating the teaching of behavioural and social sciences into dental curricula?
The thing that is probably most important, that benefits the most, is communication. We’re currently developing a completely new dental curriculum here in Bristol and we have just rolled it out to first-year students. As far as my communication skills teaching is concerned, when I go in and tell students that we’ll be discussing how to first greet your patient, they look at me like I’m daft—they’re top-level students and can be surprised by the idea that they need to improve something as simple as their communication, until you get them in a group with an actor playing a patient—then they realise that there are certain difficulties to this sort of interaction. You might be the best technical dentist in the world, but if your patient doesn’t like you, he or she is unlikely to come back for a check-up.
Another important aspect is improving students’ understanding of patient anxiety, since many patients who will come and visit them in practice will have some level of anxiety. The integration of social sciences also allows for dental students to be able to think about patient-centred care at a broader level—to think about existent health inequalities and other large-scale issues, all with an application to dentistry.
“The integration of social sciences also allows for dental students to be able to think about patient-centred care at a broader level—to think about existent health inequalities and other large-scale issues, all with an application to dentistry.”
You mention in your article that there are students who openly question the relevance of behavioural and social sciences to their studies. Can you perhaps explain why this is the current situation?
There are two primary reasons for this: the hegemony of a biomedical approach and the existence of a hidden curriculum. The former reason refers to the fact that students are coming into dental school with a very strong background in science, generally speaking, and their expectation is that they’ll be learning more “hard” science. When they’re then presented with “soft” science like this, it’s a surprise, and they need a bit of persuasion before they grasp its relevance. It can take a little bit of time to convince them, but they get there eventually.
As far as the hidden curriculum is concerned, this refers more to the student experience, not necessarily in relation to the things they are being taught, but in their experiences with people whom they perceive to be role models and the importance that these role models place on different types of knowledge. Sometimes there is a strong divide between what happens in a classroom setting and what happens in the clinical setting, and this can lead to students perceiving and prioritising their clinical experiences as more relevant to their development.
In the article, you also talk about dentistry being a “biopsychosocial” discipline. Can you elaborate on what you mean by this?
Well, many people have this assumption that dentistry is purely biomedical—it’s about how the body works, how the mouth and teeth work, facilitated by those clinical and surgical skills that dental students learn. What we’re suggesting with this term is that, while these aspects are still undeniably part of dentistry, dentists also need to consider that they’re dealing with an actual person with social experiences that will inform his or her healthcare choices.
What do you see as some of the shortcomings of the current approach to behavioural and social sciences education in dental schools, and how can these be remedied?
Well, as we mention in the article, it’s been 20 years since the role of behavioural and social sciences in UK dental schools’ curricula was reviewed, so there’s a pressing need for another review of this. Any good review should gather information from all the dental schools teaching social science, and although it’s a relatively small world, we’re not all necessarily teaching the same things in the same way. So we should aim to achieve a consensus regarding what needs to be taught in this discipline and then work on implementing this.
Editorial note: Waylen’s article, titled “Why UK dental education should take a greater interest in the behavioural and social sciences”, was published online on 25 October 2019 in the British Dental Journal.